Paradoxical Embolism: What You Need to Know
Paradoxical embolism is a rare but serious condition in which a blood clot forms in a vein and then travels through a hole in the heart to an artery, blocking blood flow to an organ or tissue.
What causes paradoxical embolism?
Paradoxical embolism is most often caused by a condition called a patent foramen ovale (PFO). A PFO is a small hole in the heart that is present in about 25% of the population. In most cases, the PFO closes on its own after birth. However, in some people, the PFO remains open, allowing blood to flow from the right atrium to the left atrium.
If a blood clot forms in a vein, it can travel through the PFO and into the left atrium. The clot can then be pumped out to an artery, where it can block blood flow and cause a stroke, heart attack, or other serious medical problem.
What are the risk factors for paradoxical embolism?
The risk factors for paradoxical embolism include:
* Having a PFO
* Having a history of deep vein thrombosis (DVT) or pulmonary embolism (PE)
* Being pregnant
* Taking certain medications, such as birth control pills or hormone replacement therapy
* Having a heart condition, such as atrial fibrillation or mitral valve prolapse
What are the symptoms of paradoxical embolism?
The symptoms of paradoxical embolism depend on which organ or tissue is affected by the blood clot. Common symptoms include:
* Chest pain
* Shortness of breath
* Stroke symptoms, such as facial drooping, arm weakness, or speech difficulty
* Vision problems
* Weakness or numbness in an arm or leg
* Abdominal pain
* Nausea and vomiting
How is paradoxical embolism diagnosed?
Paradoxical embolism is diagnosed based on the patient's symptoms, a physical examination, and imaging tests. Imaging tests that may be used to diagnose paradoxical embolism include:
* Echocardiogram
* Transesophageal echocardiogram
* Computed tomography (CT) scan
* Magnetic resonance imaging (MRI) scan
How is paradoxical embolism treated?
The treatment for paradoxical embolism depends on the severity of the condition and the underlying cause. Treatment options may include:
* Anticoagulant medication to prevent blood clots from forming
* Surgery to close the PFO
* Thrombolysis to dissolve the blood clot
* Embolectomy to remove the blood clot
What is the prognosis for paradoxical embolism?
The prognosis for paradoxical embolism depends on the severity of the condition and the underlying cause. With prompt diagnosis and treatment, most people with paradoxical embolism recover fully. However, some people may experience long-term complications, such as stroke, heart attack, or chronic pain.